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BACKGROUND: Cardiovascular disease is the major cause of morbidity and mortality. It is well known that androgen and sex hormone-binding globulin(SHBG) in women were associated with risk factors for cardiovascular disease such as obesity, central fat accumulation and atherogenic lipid profile. High resolution B-mode ultrasonography can visualize directly both luminal and vessel wall characteristics, and ultrasonic measurement of carotid intima-medial thickness(IMT) can be used to investigate the atherosclerosis of coronary, cerebral and peripheral arteries. The aim of this study was to evaluate the relationship between the serum dehydroepiandrosterone sulfate(DHEA-S) and SHBG, and body fat distribution pattern, cardiovascular risk factor and carotid atherosclerosis in women. METHODS: Blood pressure, fasting serum glucose, insulin, lipid profile, SHBG and DHEA-S were measured. Body fat distribution pattern was assessed by waist to hip ratio, waist to thigh ratio and subscapular to triceps skin fold thickness ratio, faf mass measured by bioelectric impedance analyzer, subcutaneous fat area, visceral fat area, and visceral to subcutaneous fat area ratio(VSR) at the level of umbilicus using the computed tomography. The IMT of the carotid artery was measured by high resolution B mode ultrasound as a marker of atherosclerosis. RESULTS: 1) There was no significant difference of age-adjusted values of carotid IMT among subjects with NGT(0.426+/-0.09mm), IGT(0.46+/-10.09mm) and NIDDM(0.453+/-0.11mm). 2) In postrnenopausal women, carotid IMT was greater(0.484+/-0.11mm, p=0.05) than premenopausal women(0.426+/-0.08mm), but it was not significant after age adjustment. Serum SHBG and DHEA-S levels in postmenopausal women were significantly lower(p<0.05) than premenopausal women, but they were not significant after age adjustment. 3) Carotid IMT was significantly correlated with age(r=0.37, p<0.01), fasting serum glucose (r=0.32, p<0.01), total cholesterol(r= 0.25, p<0.05), LDL-cholesterol(r=0.26, p<0.05), visceral fat area(r=0.35, p<0.01) and VSR(r=0.31, p<0.05). 4) By the stepwise multiple regression analysis, carotid IMT was positively and significantly associated with age(p<0.01) and serum DHEA-S concentration(p<0.05) in dent of age, body mass index, waist to hip ratio, fasting serum glucose. CONCLUSION: Carotid IMT was associated with age and serum DHEA-S concentration in women without cardiovascular disease. Therefore, serum DHEA-S may be one of risk factors for cardiovascular disease in women. However, we could not conclude its cause-result relationship because of cross sectional nature of our study, and prospective study will be needed.
Arteries ; Atherosclerosis ; Blood Glucose ; Blood Pressure ; Body Fat Distribution ; Body Mass Index ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Artery Diseases* ; Dehydroepiandrosterone Sulfate* ; Dehydroepiandrosterone* ; Electric Impedance ; Fasting ; Female ; Humans ; Insulin ; Intra-Abdominal Fat ; Mortality ; Obesity, Abdominal ; Phenobarbital ; Risk Factors ; Sex Hormone-Binding Globulin* ; Skin ; Subcutaneous Fat ; Thigh ; Ultrasonics ; Ultrasonography ; Umbilicus ; Waist-Hip Ratio

BACKGROUND: Urinary tract is the most common site of nosocomial infections, accounting for 35% of all nosocomial infections. About 80-90% of these urinary tract infections are associated with urethral catheter insertion. Recently, we experienced an outbreak of nosocomial UTI (urinary tract infection) caused by Candida spp. in the surgical ICU (SICU) and we investigated the cause of UTI outbreak. METHODS: We collected data from clinical records and observed the current methods of care of urethral catheters in the SlCU. During the outbreak, we investigated the current procedures and maintenance care of urethral catheter insertion and educated the staff on the correct methods of the catheter insertion and care. We performed surveillance cultures of unused new urine bags, RESULTS: Between May 2000 and June 2000, 17 Candida spp. strains were isolated from urines of 17 patients hospitalized in the SICU of National Health Insurance Corporation Ilsan Hospital. All infections were attributed to the care of urethral catheter insertion and contaminated bags. We identified that routine bladder irrigation and emptying urine to a common urinal have been done incorrectly during the outbreak period. Rodotorula spp. was isolated from 4 urine bags (50% contamination rate) out of 8 unused new urine bags by surveillance cultures. CONCLUSION: The causes of the UTI outbreak caused by Candida spp. was terminated by outbreak investigation and change of contaminated urine bag.
Candida* ; Catheters ; Cross Infection ; Humans ; National Health Programs ; Urinary Bladder ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Recently malaria infection became one of the most important parasitic diseases in Korea. After the re-emergence of malaria in a young soldier in 1993 near the De-Militarized Zone (DMZ), three to four thousand people have been infected per year in the last few years and the cases of infection have been increasing threefold each year. Microscopic examination of a thick blood smear is a conventional and confirmatory method for diagnosis. However, it requires labor-intensive procedures and its interpretation is quite subjective. Faster and more reliable methods are needed for the diagnosis of malaria. METHODS: We evaluated 155 patients who were diagnosed as malaria. We performed point-of-care rapid diagnostic methods recently introduced: two antibody detection tests manufactured by Korean companies and one antigen (Plasmodium lactate dehydrogenase, pLDH) detection test. The results were compared with those of microscopic examinations of thick blood smears. RESULTS: Sensitivities of two antibody detection assays and one antigen detection assay in acute attacks of malaria were 64.7%, 72.5%, and 96.1%; and, specificities were 88.5%, 89.4%, and 95.1%, respectively. Overall accuracy for all samples were 80.6%, 83.9%, and 95.5%, respectively. CONCLUSIONS: Antibody detection tests for malaria have limitations in sensitivity and accuracy to replace microscopic examination of blood film. Antigen tests detecting pLDH could replace conventional microscopic examinations of blood film, especially in emergency situations in cases that require prompt medication.
Diagnosis* ; Emergencies ; Humans ; Korea* ; L-Lactate Dehydrogenase ; Malaria* ; Military Personnel ; Parasitic Diseases ; Plasmodium

PURPOSE: This study has examined effectiveness of a secondhand smoking prevention program for adolescents. METHODS: The study was done in a nonequivalent control group pretest/posttest design. The subjects of the current study were 198 middle school students from K city in the Gyeongbuk province. The students were assigned to an experimental group (100) and participated in the secondhand smoking prevention program or to a control group (98) and did not take part. Data collection was done from June to July 2012. A Chi-square test, independent t-test, paired t test and ANCOVA were used with the SPSS 18.0 program for data analysis. RESULTS: There were significant differences between the groups in knowledge of short-term influence of secondhand smoking (F=9.65, p<.005), knowledge of long-term influence of secondhand smoking (F=15.53, p<.001), verbal coping skills for secondhand smoking prevention (F=16.35, p<.001), behavioral coping skills for secondhand smoking prevention (F=8.49, p<.005), and assertiveness of secondhand smoking prevention (F=17.30, p<.001) measurements. CONCLUSION: The secondhand smoking prevention program delivered to the adolescents is an effective method of encouraging secondhand smoking prevention and can be utilized as an effective nursing intervention for adolescents.
Adaptation, Psychological ; Adolescent* ; Assertiveness ; Data Collection ; Gyeongsangbuk-do ; Humans ; Nursing ; Smoking ; Statistics as Topic ; Tobacco Smoke Pollution*

BACKGROUND: Transcranial Doppler Ultrasonography (TCD) is a non-invasive and easily applicable method to evaluate cerebral hemodynamics. The objective of this study is to evaluate the diagnostic value of TCD parameters detecting high-grade extracranial carotid stenosis. METHODS: The subjects were 17 patients who showed high-grade carotid stenosis (>75%) or occlusion on cerebral digital subtraction angiography (DSA) and 18 patients whose DSA were normal. TCD parameters were reversed ophthalmic artery flow (OR), reversed anterior cerebral arterial (ACA) flow (AR), increased flow velocity of contralateral ACA (>80cm/sec; CA), decreased flow velocity of ipsilateral MCA (<30cm/sec; IM), absence of ICA flow at siphon(IS), reduced flow acceleration (<280cm/sec2; FA) and pulsatility index (<0.5; PI) of MCA. RESULTS: The sensitivity of each parameter was 23.5% for OR, 47% for AR, 58.8% for CA, 5.9% for IM, 23.5% for IS, 70.6% for FA and 11.8% for PI, while their specificity was 100% in all parameters, except IS, 83.3%. When AR, CA and FA are combined, the sensitivity increased up to 86.7%. CONCLUSIONS: Reduced flow acceleration of MCA and parameters related with collateral flow through the anterior communicating artery were proved to be more sensitive TCD parameters detecting high-grade extracranial carotid stenosis or occulsion than other parameters. Thus patients with abnormal TCD measurements of these parameters may need further evaluation for carotid disease.
Acceleration ; Angiography, Digital Subtraction ; Arteries ; Carotid Arteries ; Carotid Stenosis* ; Cerebral Angiography ; Hemodynamics ; Humans ; Ophthalmic Artery ; Sensitivity and Specificity ; Ultrasonography* ; Ultrasonography, Doppler, Transcranial

BACKGROUND: Many women have experienced artificial abortion, but artificial abortion itself may take a life away from a fetus and also influence serious effect on operated womens health condition. So this study was attempted to offer basic information for improving maternity health condition by knowing womens artificial abortion performance status and recognition about its complication. METHODS: The 215 married women who visited in OPD of certain hospital in Pusan from november 1994 to January 1995, answered the question about experience of artifial abortion the recognition about its complication, and artificial abortioned group answered the reason of artificial abortion and the experience of complication. RESULTS: The number of women who experienced artificial abortion was 107 persons(49.8%). More educated women have experienced less artificial abortion. The causes of artificial abortion were birth control as of 40.6%, continuation of occupation or study as of 20.6%, for preserving health condition as of 14.2%, impossible marriage as of 14.2%. 115 persons out of 215 persons (53.4% ) answered they heard about, its complicatons. In relation to health, 66 persons(30.7% ) answered that the abortion had no relation with health condition or they answered they have no idea about the issue, 68 persons(31.6%) answered that the abortion had relation with but its complication would be soon recovered. Higher understanding was obtained in higher educated group(P<0.05). If unwanted pregnancy occur to them in the future, 32 persons(27.8%) in recognized group and 38 persons(38%) in unrecognized group answered they would perform artificial abortion. So understanding about complicaton of artificial abortion has little effect on their artificial abortion rate. CONCLUSIONS: Recognition of complications of married women is low, and recognition degree doesnt affect artificial abortion. So, not only education about complications of artificial abortion and contraception but also social performance of sharing womens responsibility for birth control or bringing up infants is necessary.
Abortion, Induced ; Busan ; Contraception ; Education ; Female ; Fetus ; Humans ; Infant ; Marriage ; Occupations ; Pregnancy ; Pregnancy, Unwanted ; Women's Health

In air leak syndrome, a significant portion of the volume delivered during a positive pressure breath can be lost through the leak. HFOV can achieve adequate ventilation at lower peak and/or mean intrapulmonary pressure than conventional mechanical ventilation (CMV) and has been an effective treatment of already established air leak syndrome. We report a 1-day-old male infant with severe respiratory failure from pneumothorax and pneumomediastinum, who was refractory to CMV with chest tube drainage. HFOV was applied to this patient for 114 hours, and improvement of oxygenation and ventilation as well as significant reduction of pneumothorax followed.
Chest Tubes ; Drainage ; Humans ; Infant ; Male ; Mediastinal Emphysema ; Oxygen ; Pneumothorax ; Respiration, Artificial ; Respiratory Insufficiency ; Ventilation*

The meningitis occur within a closed anatomic space, so they have many similar clinical features and characteristic CSF abnormalities. But the temporal profile of many meningitis is distinctive from aseptic meningitis with spontaneous remission to bacterial or tuberculous meningitis with fatal outcome without treatment. Therefore early accurate differential diagnosis is required. The development of diagnostic tools and treatment, and increase of immunodeficient state and resistant pathogens have changed the distribution of main pathogens of meningitis from the past. Therefore we analyzed 241 medical records with final diagnosis as 'infectious meningitis' to evaluate the distribution of pathogens in Korea and any differential points of clinical, laboratory, and radiologic, profile according to etiology. 1. The etiologic distributions were followings, Aseptic meningitis in 100 patient(41.5%), tuberculous meningitis in 58 patients(24.1%), bacterial meningitis in 48 patients(19.9%), and fungal in 16 patients(6.6%). 2. The intense seasonal occurrence was noted in aseptic meningitis with summer. 3. Fever and headache were noted in almost all patients Altered mental status were noted in 39.6% of bacterial meningitis, 53.41% of tuberculous meningitis but not in fungal and aseptic meningitis. Meningeal irritation signs were noted in less patients(25%) with fungal meningitis but in more with aseptic, bacterial or tuberculous meningitis m 52-66.7%. Most of all focal neurologic signs were present in bacterial or tuberculous meningitis. 4. Many immunocompromized patients had fungal meningitis, three of which showed normal CSF leukocyte counts And it pointed up the importance of intensive etiologic evaluation in immunodeficient patients with clinically suspected symptoms of meningitis. 5. CSF findings at admission were following. CSF leukocytes were mean 206-258/yL in aseptic, tuberculous or fungal meningitis. But in bacterial meningitis leukocyte counts were greater than 1,000/mL in mom than half of patients. The differential counts of leukocytes were monocyte predominant except in bacterial meningitis. The reductions of CSF sugar were noted in bacterial, tuberculous, or fungal meningitis. Characteristically all patients with extremely low CSF sugar(less than 10mg/dL) had bacterial meningitis. 6. The most frequent pathologic findings in neuroimaging study were hydrocephalus(20patients: 9.1%) and meningeal enhancement(19patient,: 8.6%). Small enhancing mass(8patients: 3.6%.) and focal infarction(8patients: 3.6%) were noted less frequently. These abnormal radiologic findings were noted in 2 patients(2.0%) with aseptic meningitis, 15 patients(38.7%) with bacterial meningitis, 29 patients(50.0%) with tuberculous meningitis and 5 patients(35.7%) with fungal meningitis.
Adult* ; Diagnosis ; Diagnosis, Differential ; Fatal Outcome ; Fever ; Headache ; Humans ; Korea ; Leukocyte Count ; Leukocytes ; Medical Records ; Meningitis* ; Meningitis, Aseptic ; Meningitis, Bacterial ; Meningitis, Fungal ; Monocytes ; Neuroimaging ; Neurologic Manifestations ; Remission, Spontaneous ; Seasons ; Tuberculosis, Meningeal

PURPOSE: The aim of this study was to examine the level of problem drinking and assess factors that influence problem drinking in Korean college women. METHODS: The participants were 500 students who took part in a self-administered online survey. AUDIT, BDI-II, AES, PSS, and PES were included in the survey used in this study. Collected data were analyzed using descriptive statistic, t-test, ANOVA, Pearson correlation coefficient, and multiple regression with SPSS/WIN 23.0 program. RESULTS: The average score for AUDIT was 8.98±6.38 and the proportion of the problem drinking was 50.8%. Significant factors that influenced problem drinking were depression, alcohol expectations, age of first drink and family income. CONCLUSION: Findings from this study suggest that the need to develop nursing intervention programs for early prevention of excessive alcohol use and recovery for college women who have a drinking problem.
Depression ; Drinking* ; Female ; Humans ; Nursing